Kinderspital Zürich – Eleonorenstiftung

Steinwiesstrasse 75
CH-8032 Zürich

www.kispi.uzh.ch

Abstract Number: DI-008

Apps for paediatric dosing

– an evaluation
Elisabeth V. Giger1, Priska Vonbach1
1Division of Pharmacy, University Children’s Hospital Zurich, Zurich, Switzerland

Objectives Conclusion
Thousands of medical apps can be found in the apple app store and google
 Several high quality paediatric dosage apps are available.
play. This huge amount makes it difficult to find an appropriate app and to
ensure quality and accuracy of an app.  The apps Epocrates, Lexicomp and Safe Dose reached the highest
Since we are interested to see whether the available apps are safe to use scores in our evaluation, followed by AGN Emergency Booklet and
and to identify areas for possible improvement, we evaluated their quality EMRA Peds Meds.
and content. This evaluation was done in accordance with the European  The calculator is the feature that could be improved in all five top apps.
Statements of Hospital Pharmacy to be involved in eHealth/mHealth pro-
 It is important to keep in mind that the appropriate medical app
cedures and to decrease the risk of medication errors (statements 1.7, 5.5).1
depends on the contents and features that are relevant for the
Our website www.kinderdosierungen.ch provides paediatric dosages in two individual user.
languages, German and French (the English version will be published soon).
To increase usability, we aim to develop a mobile version whereby the  We recommend that prior to using an app, a short evaluation is
results of our evaluation might be useful. performed.

Methods
Search for paediatric dosing apps Evaluation Table 1: In-depth evaluation of selected paediatric dosage apps
 Keywords such as paediatric, medical, app, dosing (in English or German)  Six main categories Category (weight) Criteria (examples out of 73 criteria)

 Perform a google search and search the apple app store and google play containing a total of 73 Quality/Content (35%) Updates, maximum dose, different dosages
for different indications, accuracy of dosage,
 Search between April and June 2015 criteria were chosen references
(Table 1) Quantity (10%) Number of active ingredients and preparations,
Inclusion criteria different routes of administration
 Category weights chosen
Calculator (20%) Integration, plausibility check weight/age, pre-
 Part I: Selection of apps in either English or German containing structured according to importance term calculations
paediatric dosages (preselection) for usage by healthcare Features (15%) Add bookmarks, calculation of volumes (liquid
 Part II: Selection of apps with a dosage calculator and either more than 70 professionals (Table 1) forms) or tablets (solid forms), different
therapeutic categories
active ingredients or a calculator specific for preterm infants (in-depth
 Criteria and weights Usability (15%) Data presentation, efficiency
evaluation)
defined by two experts Additional professional Adverse events, drug-drug interactions,
information (5%) compatibility

Results & Discussion

 Preselection: 43 paediatric dosage Suggestions for improvements
apps  Calculators, especially regarding integration of preterm infant
 Eighteen apps fulfilled criteria for in- calculations
AGN Critical Peds EMRA Peds Epocrates Kids Drug Kinderanästhesie
depth evaluation  Data presentation: Large amount of information to be presented
Emergency Meds Dosage Calc – XS
 Top five apps: Epocrates, Lexicomp,
Booklet Paed Rx
Important to know
Safe Dose, AGN Emergency Booklet,
 No danger to use any of the 18 evaluated apps
EMRA Peds Meds
 Quality of the dosages of seven randomly chosen active ingredients
Lexicomp Neonatology NICU PedDrugDose Pedi PediMeds  Table 2: Ranking of top five apps
Anesthesia from different drug groups (e.g. amoxicillin, furosemide, paracetamol)
within the 18 included apps for each
were evaluated and displayed correct dosage ranges
of the six categories
Pedi STAT Paediatric Pediatric IV Pediatric Quick Safe Dose Skyscape  Table 3: Summery of different details Limitation of the evaluation
 Evaluation is based on criteria/weights that two experts defined
Emergency Dosage Reference Medical Library
Drugs
together with strengths and weak-
Figure 1: Paediatric dosing app selected for in-depth evaluation2 nesses of the top five apps  End result could be different depending on criteria/weights chosen

Table 3: Details of the top five paediatric dosing apps

Languages Operation system Price (CHF) Calculator Strengths Weaknesses
Table 2: Ranking within categories for the top five paediatric dosing apps
Epocrates English Android free integrated differentiation* calculator
iOS manual calculation usability
professional

Lexicomp English Android 75 not integrated quality calculator

information
Calculator

Additional
Features

App German iOS quantity

Usability
Quantity
Content
Quality/

further languages
Rank

Safe Dose English Android free (limited number integrated features missing galenic
German iOS of medications) automatic calculation usability forms
Epocrates 3 3 15 3 3 3 1 further languages 100 (all medications)

Lexicomp 1 1 18 2 17 1 1 AGN Emergency German Android 24 integrated administrative additional professional

Booklet automatic calculation features (FAQ, information
Safe Dose 2 5 9 1 5 2 1 hard to find informations)
EMRA English iOS 3 integrated calculator additional professional
AGN Emergency Booklet 6 6 8 4 7 13 4
Peds Meds automatic calculation information
EMRA Peds Meds 10 7 1 5 7 13 5 differentiation*
*Differentiation: several indications, different dosages for different age groups

References: 1. The European Statements of Hospital Pharmacy. Eur J Hosp Pharm 2014 21: 256-258. 2. Ralf Müller (2016), AGN Emergency Booklet (Version 11.6.4); David Alden (2014), Critical Peds (Version 1.3); EMRA (2015), EMRA Peds
Meds (Version 1.1.0); Epocrates (2016), Epocrates (Version 15.12.1); logicmantra (2013), Kids Drug Dosage Calc - Paed Rx (Version 1.0); Dr. Steve-Oliver Mueller (2015), Kinderanästhesie XS (Version 1.1.1); Lexi-Comp (2015), Lexicomp
(Version 2.3.3); ITDCS Ltd (2015), Neonatology (Version 1.4); Guy's and St Thomas' NHS Foundation Trust (2015), NICU (Version 2.3); Caduceus Digital Systems (2014), PedDrugDose (Version 1.1.2); Vargo Anesthesia (2016), Pedi Anesthesia
(Version 2.6); Deep Pocket Series LCC (2010), PediMeds (Version 1.2); QxMD Medical Software (2015), Pedi STAT (Version 3.3); UBQO Limited (2011), Paediatric Emergency Drugs (Version 3.1); theinviter (2014), Pediatric IV Dosage (Version 2.7);
ChildrensEmergency.com (2013), Pediatric Quick Reference (Version 2.0.1); eBroselow LLC (2015), Safe Dose (Version 4.5); Skyscape Medpresso Inc (2015), Skyscape Medical Library ( Version 2.4.5)